Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid patients in problems of living. This usually includes increasing individual sense of well-being and reducing subjective discomforting experience. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).

Client confidentiality is the legal principle that a psychiatric, psychologist, social worker, or counselor cannot not reveal information about their patients to a third party without the consent of the patient or a clear legal obligation such as in the case of imminent suicide, homicide, child abuse, elder abuse, abuse of a disabled individual, inappropriate sexual relationship with a healthcare worker, or a court order signed by a judge.

PSYCHOTHERAPY MODALITIES (available at CMPS)

Individual Psychotherapy: Individual psychotherapy involves one-on-one interaction between a therapist and a patient. The therapist may be a psychiatrist, psychologist, licensed social worker, or licensed therapist. During psychotherapy, efforts are made to understand a patient's thoughts and feelings that are involved in behaviors and decision making. The psychotherapy also involves helping the patient develop more effective strategies to manage stress and emotions, and to make more effective decisions about behaviors.

Family Psychotherapy: Family psychotherapy involves a therapist meeting with two or more members of a family. Family psychotherapy helps individual family members better understand the thoughts, motivations, feelings, and behaviors of other family members. Communication improves and family members make more effective behavior choices.

Couples Therapy: This is a modality of choice when communication problems between two individuals involved in an intimate relationship are causing stress and disharmony. The client and focus of treatment, in this case, is on the relationship, not the individuals. Without "taking sides", the therapist focuses on how the individuals involved in the relationship can better understand and express their needs within the context of better understanding the emotional needs and messages of the other. Development of problem resolution strategies is the goal so that the relationship, as a whole, is healthier and able to withstand the stresses of everyday life as well as crises.

Group Psychotherapy: Group psychotherapy involves a therapist meeting with a group of people with similar types of emotional issues. During group psychotherapy, patients learn how other people react and cope. Together each individual in the group learns ways of presenting themselves, reacting, and coping which they may never have in the past realized or considered were possible. The group members learn and grow together by sharing their feelings and reactions in a safe, confidential environment led by a psychotherapist who is experienced in this type of treatment.

PSYCHOTHERAPY TECHNIQUES / MODELS / SCHOOLS / SYSTEMS (which may be utilized at CMPS)

Psychodynamic psychotherapy is a form of insight-oriented "talk therapy" the primary focus of which is to explore underlying conscious or unconscious causes of how a patient may be feeling or acting. The interpersonal relationship between the patient and the therapist is crucial to allowing for trust to occur and for reactions that occur within the therapeutic relationship to be explored in terms of how those reactions may impact the patient in his/her everyday life and relationships. This form of therapy tends to be more eclectic than others, taking techniques from a variety of sources, rather than relying on a single system of intervention.

Humanistic psychology is a school of psychology that is explicitly concerned with the human dimension of psychology. The meaning of behavior in the context of the nature of healthy growth is primary. The postulates of Humanistic Psychology include:

1. Human beings cannot be reduced to components.
2. Human beings have in them a uniquely human context.
3. Human consciousness includes an awareness of oneself in the context of other people.
4. Human beings have choices and non desired responsibilities.
5. Human beings are intentional, they seek meaning, value and creativity.

Behavior Therapy: Specific strategies are used to help encourage acceptable behaviors and discourage unacceptable behaviors. These strategies may include the use of positive and negative reinforcers which increase or decrease the likelihood of a behavior occurring.

Interactive Psychotherapy/Play Therapy: Interactive psychotherapy involves interaction between a therapist and a patient who cannot understand language sufficiently for a verbal psychotherapy to be completely helpful. Play therapy is a type of interactive psychotherapy used with children. There are also specialized interactive psychotherapy techniques to help clients with impairments of language, including autistic individuals.

Eye Movement Desensitization and Reprocessing (EMDR) is a specialized type of psychological treatment which has been found to have good results with individuals who have suffered from severe trauma in the past which now adversely impacts their life with severe anxiety, depression, and impact on one's relationships, job, etc. It integrates elements of many effective psychotherapies in structured protocols. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies. EMDR is an information processing therapy and uses an eight phase approach. During EMDR the patient attends to the past traumatic experiences as well as their present emotional experience in brief sequential doses while simultaneously focusing on an external stimulus. More information can be found at: http://www.emdr.com/index.htm

Cognitive-Behavioral Therapy (CBT) is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. It is focused on modifying everyday thoughts and behaviors, with the aim of positively influencing emotions. The therapist helps clients recognize distorted thinking and learn to replace unhealthy thoughts with more realistic substitute ideas. It does not exist as a distinct therapeutic technique. There are several approaches to cognitive-behavioral therapy, including Rational Emotive Behavior Therapy, Rational Behavior Therapy, Rational Living Therapy, Cognitive Therapy, and Dialectic Behavior Therapy. However, most cognitive-behavioral therapies have the following characteristics:

CBT is based on the Cognitive Model of Emotional Response.
CBT is briefer and time-limited.
A sound therapeutic relationship is necessary for effective therapy, but not the focus.
CBT is a collaborative effort between the therapist and the client.
CBT is structured and directive.
CBT is based on an educational model.
CBT theory and techniques rely on the Inductive Method.
Homework is a central feature of CBT.

For more information, see: http://www.nacbt.org/whatiscbt.htm

Dialectical behavioral therapy (DBT) is a psychological method developed by Marsha M. Linehan to treat patients with prominent difficulties with emotional reactivity, particularly in terms of anger/rage, anxiety, and extreme emotional mood swings. DBT also directly addresses issues related to self-injury and impaired interpersonal relationships.

A key component of DBT is the therapist and patient working together towards improving emotional and behavioral coping skills (core mindfulness skills, emotional regulation skills, interpersonal effectiveness skills, and distress tolerance skills). This is accomplished by discussing issues that come up during the week, and developing charts and lists to use as a diary to facilitate such discussions. Self-injurious and suicidal behaviors take first priority, followed by episodes of destructive emotional over-reactivity experienced during the week. The approach is practical and oriented toward behavior change as opposed to insight oriented understanding of the origin of symptoms. The emphasis in on "radical acceptance" of one's symptoms and simultaneously of the need to change behavior.

Psychoanalysis is a body of knowledge developed by Sigmund Freud and his followers. Psychoanalysis refers to a very intensive type of insight-oriented treatment which is based on identifying and analyzing unconscious conflicts which may be causing the patient's symptoms and problems. The psychotherapist/analyst helps to interpret these conflicts to create insight for resolution of the problems. At CMPS, Dr. Ray Roitman, LCSW has a a doctorate in Psychoanalysis and utilizes this form of treatment as necessary.